A prospective randomized multicenter trial comparing histidine-tryptophane-ketoglutarate versus University of Wisconsin perfusion solution in clinical pancreas transplantation.
We aimed to evaluate early pancreas transplant graft function after histidine-tryptophan-ketoglutarate (HTK) versus University of Wisconsin (UW) perfusion. Prospective randomized multicenter study including 68 pancreas transplantations stratified according to preservation fluid used (27 HTK vs. 41 UW). Primary endpoint was pancreas graft survival at 6 months. Serum alpha-amylase, lipase, C-peptide, HbA1C and exogenous insulin requirement were compared at several time points. Mean pancreas cold ischemia time was 10.8 +/- 3.7 (HTK) vs. 11.8 +/- 3.4 h (UW) (P = 0.247). Simultaneous pancreas-kidney transplantation was performed in 95.6% of the patients, pancreas transplantation alone in 2.9%, and pancreas after kidney transplantation in 1.5%. Six months graft survival was 85.2% (HTK) vs. 90.2% (UW) (P = 0.703). Serum amylase and lipase values did not differ between both the groups during the observation period. C-peptide levels were elevated in both the groups without significant differences at each time point. Higher exogenous insulin requirement early after transplantation in the UW group had resolved at 3 months. Six month patient survival was 96.3% (HTK) vs. 100% (UW) (P = 0.397). With a mean cold ischemia time of 10 h in this study, HTK and UW solutions appear to be equally suitable for perfusion and organ preservation in clinical pancreas transplantation.
Schneeberger
Stefan
S
Department of General and Transplant Surgery, Medical University Innsbruck, Innsbruck, Austria.
Biebl
Matthias
M
Steurer
Wolfgang
W
Hesse
Uwe J
UJ
Troisi
Roberto
R
Langrehr
Jan M
JM
Schareck
Wolfgang
W
Mark
Walter
W
Margreiter
Raimund
R
Königsrainer
Alfred
A
D000241:Adenosine / Q000494:pharmacology; D000328:Adult; D000493:Allopurinol / Q000494:pharmacology; D005260:Female; D005947:Glucose / Q000494:pharmacology; D005978:Glutathione / Q000494:pharmacology; D006085:Graft Survival / Q000187:drug effects*; D006801:Humans; D007328:Insulin / Q000494:pharmacology; D008297:Male; D008353:Mannitol / Q000494:pharmacology; D008875:Middle Aged; D009926:Organ Preservation / Q000379:methods; D019188:Organ Preservation Solutions / Q000494:pharmacology*; D016035:Pancreas Transplantation / Q000379:methods*; D010477:Perfusion / Q000379:methods; D011189:Potassium Chloride / Q000494:pharmacology; D011343:Procaine / Q000494:pharmacology; D011446:Prospective Studies; D011887:Raffinose / Q000494:pharmacology
C039984:Bretschneider cardioplegic solution; D007328:Insulin; D019188:Organ Preservation Solutions; C055206:University of Wisconsin-lactobionate solution; D008353:Mannitol; D011343:Procaine; D000493:Allopurinol; D011189:Potassium Chloride; D005978:Glutathione; D005947:Glucose; D000241:Adenosine; D011887:Raffinose